NPI | 1598875049 |
---|---|
Former Name | ANGELA LYNN SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: MI 4901004369) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MI 4901004369) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2022-05-16 |